In early rheumatoid arthritis, anticitrullinated peptide antibodies associate with low number of affected joints and rheumatoid factor associates with systemic inflammation
Authors' conclusion
Whereas ACPA associate with low counts of affected joints in early RA, RF associates with elevated measures of systemic inflammation in an ACPA-dependent manner.
Study context
- Population
- Patients with early rheumatoid arthritis (RA) classified according to the 1987 American College of Rheumatology (ACR) criteria, at the time of diagnosis
- Participants
- 1,600 patients
- Exposure
- Individual RA autoantibodies vs signs and symptoms at RA diagnosis
- Outcome
- Association of individual RA autoantibodies with individual signs and symptoms (C-reactive protein (CRP), ESR, SJC, TJC, DAS28, DAS28CRP, patient global disease activity, HAQ)
- Follow-up
- Baseline
Methodological detailsautoantibodies analysed centrally in baseline sera, multiple regression and stratified analyses
- Autoantibodies analysed centrally in baseline sera
- Multiple regression and stratified analyses
Main finding
As reported in the abstract
- All autoantibodies except immunoglobulin G (IgG) rheumatoid factor (RF) individually associated with low SJC and TJC and with high erythrocyte sedimentation rate (ESR)
- In IgM RF-negative patients, ACPA associated strictly with low number of swollen and tender joints; persisted in multiple regression and stratified analyses
- In those analyses, IgM and IgA RF instead associated with inflammation expressed as ESR
- Without any ACPA peptide reactivity, no association between RF isotypes and ESR
- Effect of RF on ESR increased with the number of ACPA reactivities, especially for IgM RF
Observational data: associations, not effects.
Further findings
Patients fulfilling the 1987 ACR criteria without taking RF into account
- Associations between IgM RF and high ESR, and between ACPA and low joint counts, remained
Original publication
In early rheumatoid arthritis, anticitrullinated peptide antibodies associate with low number of affected joints and rheumatoid factor associates with systemic inflammation. Ann Rheum Dis. Published 15 February 2024. doi:10.
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